scholarly journals 316. INCREASED RISK OF CARDIOVASCULAR DISEASE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS WHO HAVE ASYMPTOMATIC PLAQUE ON VASCULAR ULTRASOUND: A 5 YEAR FOLLOW-UP STUDY

Rheumatology ◽  
2017 ◽  
Vol 56 (suppl_2) ◽  
Author(s):  
Jyoti Bakshi ◽  
Anisur Rahman ◽  
David Isenberg ◽  
Sara Croca
Lupus ◽  
2017 ◽  
Vol 26 (14) ◽  
pp. 1463-1472 ◽  
Author(s):  
S Fasano ◽  
D P Margiotta ◽  
L Navarini ◽  
L Pierro ◽  
I Pantano ◽  
...  

Background Systemic lupus erythematosus is associated with an increased risk of cardiovascular disease. Low-dose aspirin, hydroxychloroquine and statins have been suggested to play a prophylactic role of cardiovascular events. This study is devoted to reviewing the literature on the topic and assessing the effects of these drugs in preventing a first cardiovascular event in a two-centre Italian series. Methods A PubMed search on cardiovascular prevention in systemic lupus erythematosus was performed. Moreover, systemic lupus erythematosus patients admitted to two centres from 2000–2015, who at admission had not experienced any cardiovascular event, were investigated. Aspirin, hydroxychloroquine and statin use, and the occurrence of any cardiovascular event, were recorded at each visit. Kaplan-Meier and Cox regression analyses were performed to evaluate the role of traditional, disease-related cardiovascular risk factors and of each of the three drugs in the occurrence of new cardiovascular events. Results The literature search produced conflicting results. Two hundred and ninety-one systemic lupus erythematosus patients were included in the study and followed for a median of eight years. During follow-up, 16 cardiovascular events occurred. At multivariate analysis, taking aspirin (hazard ratio: 0.24) and hydroxychloroquine for more than five years (hazard ratio: 0.27) reduced, while antiphospholipid antibody positivity (hazard ratio: 4.32) increased, the risk of a first cardiovascular event. No effect of statins emerged. Conclusion Our study confirms an additive role of aspirin and hydroxychloroquine in the primary prophylaxis of cardiovascular events in Italian patients with systemic lupus erythematosus. The lack of any detected effect in previous reports may depend on the design of studies and their short follow-up period.


2018 ◽  
Vol 77 (7) ◽  
pp. 1063-1069 ◽  
Author(s):  
Dag Leonard ◽  
Elisabet Svenungsson ◽  
Johanna Dahlqvist ◽  
Andrei Alexsson ◽  
Lisbeth Ärlestig ◽  
...  

ObjectivesPatients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) have increased risk of cardiovascular disease (CVD). We investigated whether single nucleotide polymorphisms (SNPs) at autoimmunity risk loci were associated with CVD in SLE and RA.MethodsPatients with SLE (n=1045) were genotyped using the 200K Immunochip SNP array (Illumina). The allele frequency was compared between patients with and without different manifestations of CVD. Results were replicated in a second SLE cohort (n=1043) and in an RA cohort (n=824). We analysed publicly available genetic data from general population, performed electrophoretic mobility shift assays and measured cytokine levels and occurrence of antiphospholipid antibodies (aPLs).ResultsWe identified two new putative risk loci associated with increased risk for CVD in two SLE populations, which remained after adjustment for traditional CVD risk factors. An IL19 risk allele, rs17581834(T) was associated with stroke/myocardial infarction (MI) in SLE (OR 2.3 (1.5 to 3.4), P=8.5×10−5) and RA (OR 2.8 (1.4 to 5.6), P=3.8×10−3), meta-analysis (OR 2.5 (2.0 to 2.9), P=3.5×10−7), but not in population controls. The IL19 risk allele affected protein binding, and SLE patients with the risk allele had increased levels of plasma-IL10 (P=0.004) and aPL (P=0.01). An SRP54-AS1 risk allele, rs799454(G) was associated with stroke/transient ischaemic attack in SLE (OR 1.7 (1.3 to 2.2), P=2.5×10−5) but not in RA. The SRP54-AS1 risk allele is an expression quantitative trait locus for four genes.ConclusionsThe IL19 risk allele was associated with stroke/MI in SLE and RA, but not in the general population, indicating that shared immune pathways may be involved in the CVD pathogenesis in inflammatory rheumatic diseases.


2019 ◽  
Vol 20 (9) ◽  
pp. 2154 ◽  
Author(s):  
Mercurio ◽  
Lobasso ◽  
Barbieri ◽  
Parrella ◽  
Ciervo ◽  
...  

Background and aim: Systemic lupus erythematosus (SLE) is associated with increased risk of cardiovascular disease (CVD). Among many mechanisms, accelerated atherosclerosis, endothelial dysfunction, and hypercoagulability play a main role. Here, we investigate whether inflammatory, serological and clinical markers of SLE determine and correlate with arterial stiffness in SLE patients. Materials and methods: Routine blood samples, inflammatory mediators, specific antibodies, and 24 h proteinuria were measured in 43 SLE patients and 43 age and sex-matched controls using routine laboratory assays. We also assessed arterial stiffness by measuring radial artery applanation tonometry-derived augmentation index (AI), normalized AI (AIx@75), aortic pulse pressure, central systolic, diastolic and peripheral blood pressure. Results: SLE patients showed a significantly greater arterial stiffness vs. controls, as demonstrated by the significantly higher AIx@75 and aortic pulse pressure. Interestingly, regression analysis showed that age, systolic pulse pressure, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), daily dose of glucocorticoids, and cumulative organ damage positively correlated with arterial stiffness. Conclusions: SLE patients show increased arterial stiffness which correlates with markers of inflammation, that is involved in early alterations in arterial walls. Applanation tonometry can be used to screen SLE patients for subclinical vascular damage to implement prevention strategies for CVD.


2017 ◽  
Vol 36 (12) ◽  
pp. 2727-2732 ◽  
Author(s):  
Liying Peng ◽  
Ziqian Wang ◽  
Mengtao Li ◽  
Yanhong Wang ◽  
Dong Xu ◽  
...  

Lupus ◽  
2015 ◽  
Vol 25 (1) ◽  
pp. 61-66 ◽  
Author(s):  
D Castillo-Martínez ◽  
E Marroquín-Fabián ◽  
A C Lozada-Navarro ◽  
M Mora-Ramírez ◽  
M Juárez ◽  
...  

Author(s):  
C Mendoza Pinto ◽  
MDLL Leon Vazquez ◽  
A Montiel Jarquin ◽  
H Sandoval-Cruz ◽  
MA Buendía Luca ◽  
...  

2021 ◽  
Author(s):  
wei zhang ◽  
YF Wang ◽  
Fanlei Hu ◽  
Fuai Lu ◽  
Tao Wu ◽  
...  

Abstract Objective:The apoptotic signaling pathway is obviously disordered in systemic lupus erythematosus (SLE). Natural IgM (nIgM) is important in clearing apoptotic cells and preventing them from triggering deleterious autoimmunity. B-1- and innate-like B- (ILBs) cells are the main nIgM producers. Human CD27+IgD+B cells (un-switched memory B cells) are considered ILBs. However, their functional properties in SLE remain undefined.Methods:Peripheral blood samples of 50 SLE patients and 50 healthy control were collected, and twelve SLE patients were assessed in a follow-up study. The amounts of CD27+IgD+ B cell was analyzed by flow cytometry. The IgM and IL-10 levels of CD27+IgD+ B cell were assessed by ELISPOT and qRT-PCR. SPSS 17.0 (SPSS, USA) was employed for data analysis. P<0.05 indicated statistical significance.Result:92.0% were females, 17-67 years. CD27+IgD+B cell amounts are significantly decreased in SLE patients than healthy control (p<0.01). CD27+IgD+B cell amounts were positively correlated with WBC(r=0.337, p=0.017), platelet count(r=0.396, p=0.004) and serum C3 levels(r=0.415, p=0.003), CD27+IgD+B cell amounts showed negative correlations with serum creatinine levels(r=-0.285, p=0.045), SLEDAI(r=-0.724, p=0.000), anti-dsDNA(r=-0.477, p=0.000) and CRP(r=-0.398,p=0.004). The IgM and IL-10 levels of CD27+IgD+B in SLE were decreased than healthy control (p<0.001), moreover CD27+IgD+B cells are increased in SLE cases after treatment in SLE patients than before treatment(p<0.001).Conclusion:CD27+IgD+B cell amounts are significantly decreased and it was correlated with clinical and immunological features in SLE patients. CD27+IgD+B cells had impaired function regarding IgM and IL-10 production in SLE, however, CD27+IgD+B cells amounts are recovered in SLE cases with treatment-related disease remission.


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